Vancomycin De-escalation Therapy in Patients With Pneumonia

Pneumonia Clinical Trial

Official title: Vancomycin De-escalation Therapy in Patients With Pneumonia and Negative MRSA Nasal Swab

Status Active, not recruiting

Clinical Trial Summary

This is a non-inferiority study evaluating clinical improvement rate when using MRSA nasal swabs to guide discontinuation of vancomycin for empiric coverage for MRSA pneumonia.

Clinical Trial Description

Current clinical guidelines recommend including vancomycin in initial empiric therapy if risk factors for MRSA infection are present, or there is a high incidence of MRSA locally. Prolonged exposure to vancomycin, however, has been linked with the risk of vancomycin-associated kidney failure. Studies have reported that a MRSA nasal swab may be used to predict the presence of MRSA pneumonia. Specifically, pneumonia patients with negative MRSA nasal swabs are 95-99% likely to not have pneumonia due to MRSA. There is limited data, however, evaluating the use of a MRSA nasal swab to guide vancomycin therapy. Accordingly, in this study, pneumonia patients in the intervention arm will have empiric vancomycin discontinued following a negative MRSA nasal swab. In the control arm, patients vancomycin will not be discontinued based on the MRSA nasal swab result. The rate of clinical resolution will be compared between these two study arms. ;

Related Conditions & MeSH terms

• Pneumonia

• NCT number: NCT03586362
• Study type: Observational
• Source: CAMC Health System
• Status: Active, not recruiting
• Start date: February 8, 2018
• Completion date: December 30, 2023